New Therapies and Strategies to Curb HIV Infections with a Focus on Macrophages and Reservoirs

Viruses. 2024 Sep 18;16(9):1484. doi: 10.3390/v16091484.

Abstract

More than 80 million people worldwide have been infected with the human immunodeficiency virus (HIV). There are now approximately 39 million individuals living with HIV/acquired immunodeficiency syndrome (AIDS). Although treatments against HIV infection are available, AIDS remains a serious disease. Combination antiretroviral therapy (cART), also known as highly active antiretroviral therapy (HAART), consists of treatment with a combination of several antiretroviral drugs that block multiple stages in the virus replication cycle. However, the increasing usage of cART is inevitably associated with the emergence of HIV drug resistance. In addition, the development of persistent cellular reservoirs of latent HIV is a critical obstacle to viral eradication since viral rebound takes place once anti-retroviral therapy (ART) is interrupted. Thus, several efforts are being applied to new generations of drugs, vaccines and new types of cART. In this review, we summarize the antiviral therapies used for the treatment of HIV/AIDS, both as individual agents and as combination therapies, and highlight the role of both macrophages and HIV cellular reservoirs and the most recent clinical studies related to this disease.

Keywords: AIDS; HAART; HIV; HIV reservoirs; antiretroviral therapy; cART; entry inhibitors; integrase inhibitors; macrophages; protease inhibitors; reverse transcriptase inhibitors.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-HIV Agents / pharmacology
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Disease Reservoirs / virology
  • HIV Infections* / drug therapy
  • HIV Infections* / virology
  • HIV-1* / drug effects
  • HIV-1* / physiology
  • Humans
  • Macrophages* / drug effects
  • Macrophages* / virology
  • Virus Latency* / drug effects
  • Virus Replication / drug effects

Substances

  • Anti-HIV Agents

Grants and funding

This work was supported by PRIN (Progetti di Rilevante Interesse Nazionale), Grants 2017M8R7N9_004 and 2020KSY3KL_005 from MUR, Italy (S.A.); PRIN 2022 PNRR, Code P20222BLAZ—Enhanced Pharmacological Activity of Noble Metal Carbene-N-heterocyclic Complexes by Oligopeptide Counterion (CUP MASTER: D53D23016900001) and PRIN 2022, Code 2022HARH5W—HyMTA (Hybrid Multi-Target Agents) (CUP MASTER: C53D23004490001) (M.S.S.).